PUKKA-J PROVIDES INNOVATIVE SOLUTION FOR EAST KENT HOSPITALS NHS TRUST

Pukka-j recently provided a 1.6 TB Nuclear Medicine Image Store to East Kent Hospitals NHS Trust. The Store centrally archives nuclear medicine data from three hospital sites within the Trust: Kent & Canterbury Hospital, Queen Elizabeth the Queen Mother Hospital, Margate and William Harvey Hospital in Ashford. It provides a robust archive with images viewable at all three hospital sites. Within the system, the original proprietary files can always be accessed, as well as the automatically generated DICOM version.

The Trust had some clear objectives when it set out to find a solution for the storage and review of its nuclear medicine data. Mr. Andrew Kettle, Principal Medical Physicist, says:

Nuclear Medicine imaging systems in routine use are never ‘state-of-the-art' computer platforms . They are often not fully supported by the supplier as they have been superseded by a new platform, and, if DICOM-enabled, may well not have all the functionality to communicate effectively to the current PACS system being installed. Systems not DICOM-enabled will have to be routed through a third party broker to convert to DICOM or else be limited to a frame-grab scenario.

A personal view is that we are a long way off being able to use CfH PACS storage for a repository for all our nuclear medicine data when our legacy equipment will have a clinical working life of up to ten years. In reality, therefore, we needed local storage with retrieval of the native proprietary file format back to the workstations. This is what the Pukka-j solution provides, with the addition of being able to view the archived image data with a browser-enabled PC or other workstation.

Some of the issues raised by East Kent Hospitals NHS Trust for Nuclear Medicine imaging and PACS are also identified by IHE, and are pertinent for other Nuclear Medicine sites and the Connecting for Health national program. For instance, the specifications regarding Nuclear Medicine image format and display are higher than those available with current PACS systems. Indeed the complexity of storage, retrieval and reporting of nuclear medicine images can often mean that nuclear medicine is a low priority in RIS/PACS terms, especially as it is not yet compliant with RIS/PACS standards.

Installation Schematic for East Kent Hospitals.

One of the positive points of dealing with a small Company is the attention that can be dedicated to individual projects. The East Kent Hospitals' project was no exception. The solution provided by Pukka-j addresses all the critical issues raised by the Trust, with the result that the Trust now has a dedicated, robust, on-line Nuclear Medicine archive that stores data in proprietary file format. It is able to recall proprietary files to the corresponding workstation for re-analysis and can view stored image data independent of the platform, and supports DICOM Query/Retrieve.

The Store itself is based on a dual RAID architecture using Pukka-j ‘Dicom Explorer' software. There is a RAID 1 mirror for the operating system and a separate 1.6TB RAID 5 for the data. The system has triple redundant hot swappable power supplies, hot swappable fans as well as hot swappable disks. The system specification is a highly robust departmental DICOM Server.

The specific requirements of nuclear medicine image format are catered for with multiframe and dynamic display, gated SPECT display and nuclear medicine hanging protocols. The image display is also tailored specifically to nuclear medicine with separate adjustment of upper and lower window levels. Multiple ‘cines' can be run if required; greyscale and colour result screens can be displayed and also dynamic result screens. Local colour tables can also be applied to greyscale screens and colour tables can be added to the system including the ability to change the intensity of greyscale result screens. It uses “intelligent” scaling to avoid presenting postage-stamp sized nuclear medicine images; this is important, as although acquisition can take place at 64 x 64 pixels, it doesn't always mean that the user wants to review the images at the original resolution. The system therefore allows the user to select different vectors/framesets of complex multi-frame images, and it also allows the user to separately adjust intensity for different framesets (e.g. phases) in the same “image”.

The Pukka-j Nuclear Medicine Image Store co-exists with PACS. As and when Radiology PACS is fully developed and proven to handle all Nuclear Medicine images, the Nuclear Medicine Store data could easily be migrated to the Radiology/Nuclear Medicine compliant PACS.

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